Monday, January 25, 2010

An ancestral amputation?

It seems that relatively advanced medical knowledge might have existed far earlier than previously imagined. The Daily Mail reports:

Evidence of surgery carried out nearly 7,000 year ago has emerged – suggesting our Stone Age ancestors were more medically advanced than first thought.

Early Neolithic surgeons used a sharpened flint to amputate the left forearm of an elderly man, scientists have discovered.

And, more remarkable yet, they ensured the patient was anaesthetised and the limb cut off cleanly while the wound was treated afterwards in sterile conditions.

Scientists unearthed evidence of the surgery during work on tomb discovered at Buthiers-Boulancourt, about 40 miles south of Paris.

It suggests an incredible degree of medical knowledge was available in 4900 BC and the revelation could force a reassessment of the history of surgery.

Researchers have also recently reported signs of two other Neolithic amputations in Germany and the Czech Republic.

It was known that Stone Age doctors performed trephinations, cutting through the skull, but not amputations.

‘The first European farmers were therefore capable of quite sophisticated surgical acts,’ said a spokesman for the French National Institute for Preventive Archaeological Research.

Cécile Buquet-Marcon and Anaick Samzun, both archaeologists, and Philippe Charlier, a forensic scientist, discovered the Neolithic surgery while researching the tomb of an elderly man.

. . .

Tests showed that the humerus bone had been cut above the trochlea indent at the end ‘in an intentional and successful amputation’.

Mrs Buquet-Marcon said that the patient, who is likely to have been a warrior, might have damaged his arm in a fall, animal attack or battle.

‘I don’t think you could say that those who carried out the operation were doctors in the modern sense that they did only that, but they obviously had medical knowledge,’ she said.

A flintstone almost certainly served as a scalpel.

Mrs Buquet-Marcon said that pain-killing plants were likely to have been used, perhaps the hallucinogenic Datura.

‘We don’t know for sure, but they would have had to find some way of keeping him still during the operation,’ she said.

Other plants, possibly sage, were probably used to clean the wound.

‘The macroscopic examination has not revealed any infection in contact with this amputation, suggesting that it was conducted in relatively aseptic conditions,’ said the scientists in an article for the journal Antiquity.

The patient survived the operation and, although he suffered from osteoarthritis, he lived for months, perhaps years, afterwards, tests revealed.

There's more at the link. Very interesting stuff.

I can't say I'm all that surprised to read this. After all, our distant ancestors hunted animals for food, and would have been accustomed to dismembering them to get the meat off the bones. They must surely have made the connection between their food and themselves, particularly since accidents and warfare (such as it was in those days) would have shown them that their own bodies were like those of the animals they hunted - they bled, had bones that could break, and so on. Experience with wounds (which must have been frequent in those primitive times) would rapidly teach them what treatments would work, and which would not. Amputation would probably be quickly learned, taking rather less time than (say) the understanding of which herbs were antiseptic and aided healing.



John Peddie (Toronto) said...

I'd always wondered about the anaesthetics, and what the Incas used.

Those early peoples knew a lot more than we moderns typically give them credit for-a humbling reminder for us.

The Errornets will tell you that the first successful operation using anaesthetics was done in 1847. Shows you how blinkered some peoples' thinking is.

Anonymous said...

I'd assume that the Inca and their predecessors used a form of coca, since it was/is common, well-known and doesn't require a lot of preparation, depending on how the dose is administered. A derivative is still used as a topical anesthetic in some ocular surgeries today.

Anonymous said...

Anesthetics could also mean something as simple as an herb that puts you to sleep.

I've heard someone make the case that humans, instead of evolving to the better, might actually be dumber now than they used to be. Some days I wonder if that is true.


Jenny said...

Stone blades can get wicked sharp - I've heard knappers talk about obsidian being used for scalpels in the modern era.

IIRC, there is a reference to the use of a naturally occurring anesthetic in a medieval monk's writings as well (I fear I can't recall the source). However, the reviewer mentioned that little things like working out proper dosage and monitoring hadn't been perfected - death was fairly common.

All that said, I'll take modern medicine over the old lady who knows her herbs any day, thank you. :)

LabRat said...

One of my perpetual pet peeves is the casual modern assumption that ancient humans were stupid. No; they were anatomically identical to us, and just as smart, thousands of years ago. Having less accumulated cultural knowledge and fewer ways to spread it does not equate to stupid.

The Greeks were not the first to make a connection between butchered animals and human anatomy, only the first to write it down in a lasting format.

Geodkyt said...

The only problem with trying to knock your patient out for surgery is NOT keeping them from feeling pain; it's waking them up afterwards.

Most traumatic injuries requiring amputation are not something you'd generally like to wait around for the minor anagesic effect which you CAN safely use. (Keep in mind that, for surgical purposes, opimum in the form of laudnum is only "analgesic".)

I'll be willing to bet that Surgical Shamen Og probably used the same pain relief measure his 18th Century peers used -- "surgical velocity".

Get the operation over quickly, and you can safely give enough analgesics to take the edge off, post op.

Try and dope the patient up heavily enough pre op to make the procedure bearable, and he'll probably die.

There's a reason the gas passer is probably the most highly trained and paid guy in the OR.